A laceration is a tear or ragged opening in the skin usually caused by an injury or trauma. A laceration may be either a partial laceration or a complete laceration. Since the nerves of the hands are located very close to the nerves, a laceration may damage them as well, causing numbness in your fingers.
Causes
Nerve lacerations may be caused by blunt trauma such as a sudden blow or a fall or by sharp objects such as a knife or broken glass.
Symptoms
The symptoms of a nerve laceration include pain, tenderness, and inability to bend the joints of your finger or a secondary compensatory deformity. Lacerated nerves often cause pain and numbness in the fingers.
Diagnosis
The diagnosis of a nerve laceration is made on the basis of your history and physical examination. An X-ray may be taken to rule out any fractures or foreign bodies. An ultrasound may help to confirm the diagnosis of a lacerated nerve and localize the proximal end of the retracted nerve but may be inaccurate in the acute setting. If the nerves are lacerated, Dr Bala may order an electromyography (EMG) or nerve conduction velocity (NCV) which is an electrical conduction test to determine the extent of damage to the nerve. Sometimes, an MRI Neurography or CT scan also may be recommended.
Treatment
Nerve laceration may require nerve repair using microvascular techniques if there is no nerve substance loss. If there is nerve substance loss a nerve graft may be required which may be harvested from the patients’ own body.
Dr Bala uses special magnification loupes during surgery to visualize and protect these important structures to minimize complications. He has been trained in nerve repair with techniques his mentors have acquired from the Kleinert Institute, Kentucky USA. Aggressive hand physiotherapy is usually prescribed to regain range of motion, strength and function after nerve healing.
